Independent Payment Advisory Board (IPAB)

The Independent Payment Advisory Board (IPAB) was established in 2010 by the Patient Protection and Affordable Care Act (ACA). The IPAB is a 15-member body of unelected, unaccountable officials that will make recommendations to "reduce the per capita rate of growth in Medicare spending." The IPAB is distinctly different from the Medicare Payment Advisory Commission (MedPAC), the independent body charged with advising Congress on issues relating to Medicare spending; while Congress currently is not bound to implement recommendations from MedPAC, it will be required to either implement the recommendations of the IPAB or develop alternate proposals to bring costs in line with targets.

What You Should Know

The IPAB may not make recommendations that would cause a "rationing" care, restrict benefits, change eligibility criteria, or increase revenues, beneficiary premiums or cost-sharing, the board will be left with few options apart from making cuts to providers. The impact this will have on beneficiaries will be reduced access to highly specialized care and innovative therapies that improve beneficiary health and quality of life. Funding for the IPAB has already been appropriated, and reports and recommendations will be forthcoming. By law, the IPAB may not include individuals directly involved in the provision or management of the delivery of Medicare items and services, or engage in any other business, vocation, or employment. This means that the IPAB's composition prevents the appointment of practicing physicians with the clinical expertise to care for Medicare beneficiaries.

What the AUA is Doing

The AUA, together with other groups, is advocating for a repeal of the IPAB.